“How do I know if I need pelvic floor and core physical therapy?” “I can sneeze without peeing so does that mean everything is healed the way it should be?” “What should I be looking for to know that I am on the right track?” “How do I know if I am doing exercises to help me, or that make things worse?” “Why am I still having struggles 5 years after birth? 10 years after birth? (etc)”
These are questions I get asked out in the community a lot by new moms, as well as not-so-new moms. I understand the confusion. There are a lot of misconceptions out there about postpartum healing. One of the biggest is that POSTPARTUM IS FOREVER! And please don’t let that strike you as a negative statement because once you have carried a baby and gone through childbirth, you are technically in a “postpartum” body….and probably the shift in your life is something that you would never ever want to change....AND it is never too late to tap into more movement, strength, and stability. Just like in anyone - male, female, parent, not a parent, athlete, not an athlete, etc. And let’s be real, it’s not just following birth where a lack of neuromuscular connection to our center, our core, our root, our stability system can be an issue - things like injury, chronic pain, digestive issues, surgery, posture habits, and movement habits can all affect the neuromuscular connection in our bodies. We defined our actual core system a few blogs ago (see video in the blog entitled "What Type of Physical Therapist am I?) and it may have surprised some people that it is not all about the abs! It is a SYSTEM of muscles which your brain has to have a connection to, and which need to work in coordination - considering the breath and alignment of our skeleton - to truly be strong. Everything we do goes through our core - it’s job is to provide a stable foundation for all of our movements. If you have any weakness or the patterning is off, you are actually leaving some of your power untapped! So what are some signs to look for that may suggest your core is not functioning at it’s full potential:
1) Back, pelvis, hip, or shoulder pain. If your center is not providing a stable base to move from, other joints and muscles have to compensate and alter their movement. This ripple effect in the body can lead to pain over time.
2) “Pooching” or doming in your lower abdomen. As mentioned above, the system is designed to recruit muscles in a certain way - your deep core, including transversus abdominus and pelvic floor are meant to turn on first and create a sort of "corset" to hug your abdomen and stabilize for larger movements. When that is altered, you can continue to feel that you do not have stability through your center, or a flat stomach, even if you are doing a lot of "core work". These muscles are easy to lose connection to, especially following pregnancy because they are quite literally stretched out and in a different position for a period of time. When they don't fire first, you can see some doming in your abdomen when you are trying to contract and use your core.
3) Unwanted leaking of urine, gas, or bowels. Although common, it is NOT “normal” to leak a little pee when you jump or sneeze, even after having a baby! This is a sign that something is off! This is also true for: needing to run to the bathroom more often, needing to empty the bladder before exercise, sneaky leaks of gas during exercise or movement, and any problem controlling the bowels.
4) A hernia, or any feelings of “pressure” or “heaviness” in your abdomen or pelvic area.
5) Chronic tightness in the same muscle group even though you feel like you stretch often. Typical offenders are the hamstrings, adductors, hip flexors, and paraspinals. When you give your body deep, inner stability, the muscles have a chance to feel safe and “let go” of their protective guarding.
6) Tired body/feeling of fatigue. Our core takes care of that inner lift creating “space” in our joints. It has to work against the pull of gravity all day and when we are weak, it gets us down.
Our bodies are smart and will get things done. It will compensate for weakness or control issues by using altered movement patterns and can lead to the above symptoms. Part of my work is training women how to integrate it all together to tap into more stability and power. It’s about awareness, alignment, reconnection, and giving the body access to these muscles (teaching it how to find them!) We slow things down to find space in the body and stabilize that space. The inner core controls natural spine alignment and gives a “lift” in the body. Sometimes it’s about finding movement, sometimes it’s about finding stability, because you need to have the ability to control both. Once you balance and re-connect, your body has the ability to bring it into everything you do and give you more power in activity and life. So my biased opinion and dream for moms is that it becomes standard that we go through pregnancy or birth and then automatically follow it up with an evaluation by a movement specialist as a part of our comprehensive wellness care in our healing period (along with many other disciplines of health and wellness that as a country we are so poor in providing to new moms…..but that’s another whole conversation!) Balanced body, balanced mind, balanced life.